Carotid Artery Stenting Without Post-stenting Balloon Dilatation

Overview

Journal J Neurointerv Surg

Publisher BMJ Publishing Group

Specialty Neurology

Date 2013 Sep 10

PMID 24014467

Citations 5

Authors

Atsushi Ogata

Makoto Sonobe

Noriyuki Kato

Tomosato Yamazaki

Hiromichi Kasuya

Go Ikeda

Shunichiro Miki

Toshio Matsushima

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the clinical outcome and MRI findings after carotid artery stenting (CAS) without post-dilatation.

Methods: Between May 2005 and April 2012, a total of 169 consecutive patients (61.4% symptomatic) underwent 176 CAS procedures performed with an embolic protection device (GuardWire, n=116; FilterWire EZ, n=60). All stents were deployed without post-dilatation. Periprocedural complications and mid-term outcomes were analyzed.

Results: The stroke rate was 2.3% within 30 days post-CAS (asymptomatic patients 1.5%; symptomatic patients 2.8%). Cerebral infarction occurred in one asymptomatic patient (1.5%) and one symptomatic patient (0.9%). Intracranial hemorrhage occurred in two symptomatic patients (1.9%). Post-CAS diffusion-weighted imaging (DWI) revealed a high-intensity area in 26 of 176 procedures (14.8%). Ipsilateral stroke after 31 days occurred in two patients (1.1%) and restenosis occurred in six (3.4%). A post-CAS comparison of the embolic protection devices revealed no difference in stroke incidence within 30 days and in DWI high-intensity area.

Conclusions: Our CAS procedure without post-dilatation is feasible, safe and associated with a low incidence of stroke and restenosis.

Citing Articles

Gradual Expansion of a Stent to Prevent Periprocedural Complications after Carotid Artery Stenting for Vulnerable Severe Stenotic Lesions with Intraplaque Hemorrhages: A Retrospective Observational Study.

Mori T, Yoshioka K, Tanno Y, Kasakura S Life (Basel). 2022; 12(1).

PMID: 35054523 PMC: 8781376. DOI: 10.3390/life12010131.

Poststent ballooning during transcarotid artery revascularization.

Dakour-Aridi H, Cui C, Barleben A, Schermerhorn M, Eldrup-Jorgensen J, Malas M J Vasc Surg. 2020; 73(6):2041-2049.e1.

PMID: 33253868 PMC: 8180310. DOI: 10.1016/j.jvs.2020.10.071.

Intentional Stent Stenosis to Prevent Hyperperfusion Syndrome after Carotid Artery Stenting for Extremely High-Grade Stenosis.

Mori T, Yoshioka K, Tanno Y, Kasakura S AJNR Am J Neuroradiol. 2020; 42(1):132-137.

PMID: 33184067 PMC: 7814797. DOI: 10.3174/ajnr.A6853.

Selective-versus-Standard Poststent Dilation for Carotid Artery Disease: A Systematic Review and Meta-Analysis.

Petr O, Brinjikji W, Murad M, Glodny B, Lanzino G AJNR Am J Neuroradiol. 2017; 38(5):999-1005.

PMID: 28302610 PMC: 7960390. DOI: 10.3174/ajnr.A5103.

Overlap stenting for in-stent restenosis after carotid artery stenting.

Nishihori M, Ohshima T, Yamamoto T, Goto S, Nishizawa T, Shimato S Nagoya J Med Sci. 2016; 78(2):143-9.

PMID: 27303101 PMC: 4885814.

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